Menstrual pain

and Sabine Schrör, medical journalist

Hanna Rutkowski is a freelance writer for the medical team.

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Sabine Schrör is a freelance writer for the medical team. She studied business administration and public relations in Cologne. As a freelance editor, she has been at home in a wide variety of industries for more than 15 years. Health is one of her favorite subjects.

More about the experts All content is checked by medical journalists.

Most women are familiar with period pain (dysmenorrhea) from personal experience. Usually the monthly complaints are bearable. But sometimes they become so strong that they seriously impair well-being and performance in everyday life. Read here what causes menstrual pain, what you can do yourself about the symptoms and when you should consult a doctor.

Brief overview

• Causes: Primary period pain (not due to the disease): early onset of the first menstruation, low body weight (BMI below 20), familial predisposition, psychological factors, particularly long menstrual cycle. Secondary period pain (based on an underlying disease): endometriosis, fibroids, polyps, cancer, inflammation of the genital organs, contraceptives such as the IUD.
• Treatment: For secondary menstrual pain, treat the underlying disease. For primary period pain: home remedies such as exercise, warmth, medicinal plants (e.g. lady's mantle, yarrow, chaste tree, St. John's wort), as well as acupressure, acupuncture, magnesium-rich diet, hormonal contraceptives, pain reliever and anticonvulsant medication, hormone preparations.
• When to the doctor In the case of sudden menstrual pain, painful bleeding after the menopause, noticeable changes in the severity and duration of the menstrual pain, and changes in the bleeding.
• This is what the doctor does: Talk to the patient (anamnesis), gynecological examination, possibly imaging procedures such as ultrasound or magnetic resonance imaging (magnetic resonance imaging, MRI).

Period pain: causes

Many women suffer from pelvic cramps just before and during menstruation. Sometimes the pain even radiates into the back. Often there are other symptoms such as headache, diarrhea, nausea and vomiting. The pain is triggered by contractions of the uterine muscles. During menstruation, it contracts like a spasm in order to expel the uterine lining that is newly formed every month if fertilization does not occur.

Period pain can be divided into:

• Primary menstrual pain: They appear with the first menstrual period (menarche) and accompany the affected women through the menopause. There is no physical illness.
• Secondary period pains: They usually only show up from the age of 30 or 40 and are based on a gynecological disease. Mostly endometriosis is behind it. The lining of the uterus settles outside the uterus ("dispersed uterine lining"). Polyps, fallopian tube inflammation and contraceptives such as the IUD can also cause secondary menstrual pain.

Causes of Primary Period Pain

Primary menstrual pain particularly affects young, very slim women from their first period. It is estimated that between 30 and 50 percent of all women of childbearing age suffer from these period pains.

The following factors favor primary dysmenorrhea:

• early onset of the first period (from approx. 12 years)
• Low body weight: Very slim women (BMI below 20) suffer more often from primary menstrual pain.
• Family predisposition: This is an advantage if the mother or sisters also suffer from period pain.
• a particularly long menstrual cycle

• mental stress such as fear or stress

Causes of Secondary Period Pain

Organic diseases are responsible for secondary menstrual pain, for example:

• Endometriosis: It is the most common cause of secondary menstrual pain. Those affected have uterine lining scattered around their bodies, especially in the pelvis. The pieces of mucous membrane, like the mucous membrane within the uterus, are subject to hormonal changes during the menstrual cycle. When menstruation occurs, they begin to bleed. Severe menstrual cramps and painful intercourse suggest endometriosis. Other signs include irregular cycles and spotting.
• Fibroids and polyps: These are benign growths on the muscle wall of the uterus (uterine fibroids) or the lining of the uterus (uterine polyps). They can cause spotting and menstrual pain.
• Cancer: Malignant tumors of the genital organs such as cervical cancer or ovarian cancer often grow unnoticed and painless at first. At some point, however, the first symptoms appear. Especially with long-lasting, unusual bleeding or brown discharge after the menopause, you should be vigilant and definitely consult a gynecologist - such symptoms can be a sign of cancer.
• Inflammation of the genital organs: An ascending vaginal infection (colpitis) can lead to chronic inflammation of the fallopian tubes, which causes severe menstrual pain and discomfort during ovulation.
• Contraceptives: A common side effect of the IUD (intrauterine device, IUD) is menstrual cramps. These include period pain and increased bleeding.

Period pain: treatment

In the case of secondary menstrual pain, the underlying disease must always be treated.

There are a number of things you can do about primary period pains yourself. Various home remedies and herbal supplements have proven effective. There are also pain relievers and antispasmodic medications for severe complaints.

Medication for period pain

• Painkillers: Especially the group of non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) with active ingredients such as ibuprofen, paracetamol and acetylsalicylic acid relieve pain effectively. However, these drugs can attack the lining of the stomach. It can therefore make sense to take a preparation that protects the stomach at the same time.
• Antispasmodics: So-called antispasmodics such as butylscopolamine relax the muscles and so relieve menstrual pain.
• Hormone preparations: Women who currently do not want to become pregnant can be treated well with hormonal contraceptives such as the pill with the active ingredient chlormadinone acetate (CMA). The artificial hormones slow down the build-up of the uterine lining during the cycle. With the monthly bleeding, less mucous membrane is shed, so that the bleeding is significantly weaker. Often they even completely eliminate menstrual pain.

Period pain: home remedies

Various home remedies can help relieve period pain. You can use these at home with little effort.

Warmth relieves menstrual pain

Many women find warmth to be a pleasant remedy for menstrual pain. Because warmth relaxes the cramping muscles in the abdomen. A hot bath can help relieve menstrual cramps. Bathe in water at around 38 degrees for 15 to 20 minutes - it is relaxing.

Apart from that, various warming home remedies are suitable for use on the stomach.

Belly pad with chamomile

A hot and humid belly pad with chamomile has a pain-relieving, antispasmodic and relaxing effect. To do this, pour half a liter of boiling water over one to two tablespoons of chamomile flowers.Leave the brew covered for a maximum of five minutes and then strain off the plant components.

Then place a rolled up inner cloth in a second cloth and roll the whole thing up into a wrap. Let this soak through the hot tea with the ends hanging out and then wring it out (caution: risk of scalding!).

Then place the damp inner cloth around your stomach without wrinkles. Fix the cloth with a dry towel. Remove the pad after 20 to 30 minutes and rest for half an hour after use.

Read more about the effects of chamomile in the medicinal plants article about chamomile.

Potato wraps

A potato wrap on your stomach can also help relieve menstrual pain. The potatoes store heat particularly well and give it off for a long time.

You can find out how to prepare and use a potato wrap here.

Dry warmth

A warm grain pillow (cherry stone pillow) or a hot water bottle are also suitable as home remedies for menstrual cramps.

Only use these home remedies for as long as the heat is comfortable. People with heart disease or neurological complaints should always consult their doctor before using heat.

Tea for menstrual pain

What to do if you have period pain To drink tea! Because many medicinal herbal teas have a pain-relieving effect, relieve cramps and relax. Teas made from the following medicinal plants are particularly suitable for menstrual cramps:

• anise
• Verbena
• Melissa leaves
• sage
• ginger
• Lady's mantle
• yarrow
• Chaste tree
• Johannis herbs

You can find out how to properly prepare and use the teas in the corresponding medicinal plant articles.

More tips for menstrual pain

Abdominal massage: A gentle abdominal massage can stimulate the natural bowel movement, relieve tension and thus also help against menstrual pain. To do this, stroke the stomach with both hands and gently pressure in a clockwise direction for several minutes.

Movement: The painful contractions of the uterus are associated with a reduced blood flow to the organ. This can make the pain worse. Gentle sports such as yoga, Nordic walking or cycling stimulate the blood circulation, loosen the muscles in the small pelvis and thus help against pain.

Even a walk is often enough to relieve acute menstrual cramps.

Diet: Legumes, whole grain rice and nuts contain a particularly high amount of magnesium, which prevents cramps of all kinds.

Acupressure: Acupressure can also relieve menstrual pain. A study has shown the effect of three acupressure points against period pain. These sit

• a hand's width below the navel
• on the inside of the knee, about a hand's breadth below the knee joint
• on the lower back in the area of ​​the lumbar dimples

Gently apply pressure to these points with your hand and massage the areas. If you have any questions about this, contact your doctor or an alternative practitioner.

According to the study, acupressure can prevent menstrual pain. Massage the points regularly for a few days before menstruation begins.

Sex: During orgasm, the body releases happiness hormones. In addition, the pelvic muscles relax during the sexual climax and the blood flow to the entire lower abdomen increases.

What helps with severe menstrual pain?

Sometimes period pains are particularly intense. Home remedies can help here too. Rather, they have a supportive effect, for example to reduce the dose and number of conventional painkillers.

If you have repeated severe menstrual pain, possibly accompanied by increased menstrual bleeding, it is advisable to consult a doctor you trust. Possibly a disease could be behind it.

Period pain: when should you see a doctor?

If you have had menstrual pain for a long time, it is usually not a cause for concern. However, you should definitely have a gynecologist clarify new period pains. If the duration or severity of the pain or the bleeding itself change, you should also consult your gynecologist. This is because vaginal infections in particular can be identified and treated at an early stage without causing secondary diseases.

Postmenopausal women should be especially careful when they experience sudden bleeding. Because these can indicate a tumor of the genital organs.

You should also see a gynecologist if you have unusually severe menstrual pain that affects you in everyday life. It may be due to endometriosis or some other condition.

Period pain: that's what the doctor does

First, the gynecologist will speak to you and ask you in detail about your symptoms and your medical history (anamnesis).

During the subsequent gynecological examination, the doctor examines the mucous membrane, vagina, uterus and ovaries in order to rule out a physical illness as the cause of the period pain. He also checks the correct fit of contraceptives such as the IUD.

Other tests such as blood tests, an ultrasound scan, or a laparoscopy (laparoscopy) may follow. Magnetic resonance imaging (MRI) or computed tomography (CT) may also be necessary - for example if endometriosis is suspected. This is often difficult to diagnose because the small foci of the uterine lining outside the uterus are not always easy to find. MRI and CT can then help

Once the doctor has identified the cause of your period pain, he will initiate the appropriate therapy.

Tags:  teenager alternative medicine organ systems